The conventional wisdom has been that a baby is considered full term if delivered between 37 and 42 weeks of pregnancy. The International Classification of Diseases defines prematurity as: Onset (spontaneous) of labour before 37 completed weeks of gestation. Two respected obstetric groups are now endorsing a new definition of full term.

The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine now label babies full term only if they are born between 39 weeks and 41 weeks. A baby born before 39 weeks is now considered early term.

One of the reasons for this change in definition is to discourage unneccessary early deliveries. Scheduled inductions and c-sections before 39 weeks can lead to complications.

Dr. Elliott Main, Medical Director of the California Maternal Quality Care Collaborative, responds to USAToday “One reason planned early deliveries have higher risks is that doctors and patients sometimes miscalculate due dates. Babies themselves are better judges, he says, as evidenced by the fact that women who go into spontaneous labor at 37 or 38 weeks tend to have healthier babies than those who choose such early deliveries.”

The last weeks of pregnancy are now divided into 4 distinct categores. Early term is between 37 weeks and 38 weeks and 6 days. Term is between 39 weeks and 40 weeks. Late term refers to a baby born after 41 weeks, and post-term applies to a baby born after 42 weeks.

The risk of infant mortality is lowest between 39 weeks and 40 weeks and 6 days. Delivery after 41 weeks has a higher risk of complications. Babies who are born spontaneously in the early term time zone are healthier than babies who are induced or electively delivered during this period of time.

This new definition can help guide decisions during these last weeks of pregnancy. Obstetricians and expectant mothers will have a more educated discussion about the risks and benefits associated with the timing of a delivery.

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48 Responses to What the new definition of “full term” means for moms

momoftwosays:

October 24, 2013 at 10:26 am

Well, this sort of stinks for me. I was aiming for 37 weeks. My first was born and almost tragically did not make it at 30 weeks. My second just barely made it to 37 (but was born healthy and that’s all that matters!). For this third, I was hoping to make it to 37, though I know that if I make it to 38 or 39, it will be better. But I have always considered 37 to be full term. I get the point, they are changing it so that people don’t induce or schedule at 37 weeks, but my dream would be to make it that far. Tomorrow I’m at 33 weeks, but already feeling as if this one’s out of my control.

Jaksays:

October 24, 2013 at 11:32 am

I think its a great law. too many mothers and doctors are scheduling these births that risk their babies lives in the name of convenience. Personally i would just outlaw any C sections that are not medically recommended, although i’m sure there are plenty of dishonorable doctors that would just recommend it for anyone and everyone to make money.
my youngest was born naturally, 3 days shy of 36 weeks at a hefty 6lbs 10oz. The guy from the NICU took one look at her, laughed and left and i also thought the whole idea of her being a preemie was pretty ridiculous, she has never been delayed in any sense, so i just ignored the silly title.
Good luck holding that babe in as long as necessary ‘momtotwo’

Thank goodness. People electing to have c/s early ô always felt they were playing god. I have always felt that doctors were taking babies too early but no one listens.

Robin Rickeysays:

October 24, 2013 at 11:58 am

I think this sounds idiotic. It will instantly redefine millions of healthy, normal births and healthy, normal newborns as pathological. Millions of mothers who didn’t quite make it to 39 weeks will be told that their babies and their bodies have something wrong with them. Will be made to feel defective and like failures.

I definitely agree with discouraging elective early deliveries, but I don’t think that changing the goalposts and redefining millions of normal millions of healthy births and babies as pathological is the way to do it. Put the responsibility on doctors not to practice irresponsible medicine. Don’t dump on the moms.

This is just one more reason for my loss of respect for the pronouncements of various medical associations.

Mandysays:

October 24, 2013 at 12:10 pm

Totally agree with this and think it’s great. My perfectly healthy SIL was “tired” of being pregnant at 38.5 week (who ISN’T!?) and had an induction at 39 weeks, which led to a c-section. While my nephew was fortunately healthy, he has had some challenges along the way that I can’t help but wonder would’ve been remedied by cooking a little longer inside. Regardless, it was stupid and selfish of her to do this but she’s one of many, I know.

Vanessasays:

October 24, 2013 at 1:07 pm

I personally don’t think elective c section should be legal or inductions either. Unless medically necessary. My little guy wad born at 40w6days. At 37, 38,even 39 weeks I was of course tired of being preggers but I just knew he wasn’t ready to come out and that’d I be pregnant for a couple more weeks. And that was ok.

Dianesays:

October 24, 2013 at 1:18 pm

I thought I had read (just a few days ago) that 37-38 weeks would be considered “early term,” not late preterm. It sounds like a silly distinction, but as one of the mothers who had spontaneous delivery at 38 weeks, I’d like to think my baby wasn’t premature. Not that it was a great delivery or anything… I just liked “early term” better, and I still think that discourages early elective births.

jillykaye273says:

October 24, 2013 at 1:18 pm

I work in a newborn ICU and for quite some time in our hospital and others across the city doctors can not perform elective deliveries prior to 38 weeks. Any scheduled c-section or induction has to have a medical reason documented or the doctors and the hospital can face serious fines and sanctions.

I am totally on board with this change. Some of the sickest babies I’ve taken care of have been born around the 37 week mark. People need to keep in mind that when doctors give you a due date, even when based on an early ultrasound, can have a margin of error + or – 2 weeks. So a baby born at 37 weeks could really be a 35 weaker.

Chloe's momsays:

October 24, 2013 at 1:20 pm

I’m not exactly sure how to feel about this…especially since my daughter was born premature in January of this year (2013). We tried everything to keep her in my oven until I was past 38 weeks…..but my beautiful little girl had other plans. I had a fairly decent pregnancy until mid way to my last trimester…and everything just got worse than we could think….we had an ultrasound done at 35 weeks and our precious baby wasn’t measuring at 35 weeks…. She had several different measurements, 33 32 and 34 weeks. And she was very concerned about her weight gain as well….she wasn’t gaining anything. They put me on Ensure three times a day and bed rest!!!! I was so worried and scared….as my other pregnancies everything went great…well I did the bedrest as much as possible with a two year old running around. Well we had to go back a few weeks later and my iron had dropped extremely low…low enough to where they were worried I’d need a transfusion….so we got my iron up just enough to that wasn’t necessary…however she wasn’t growing still…and on top of all that she stayed transverse my entire pregnancy!!! Luckily my little girl was born via C-Section (that we tried to avoid by every way possible) but she was born premature…so tiny that even newborn clothes were too big!! My little girl was born 37 weeks and 6 days….so yes she was born premature!!!And she’s doing amazing now!! Standing and talking crawling I am truly blessed. But the more I think about this…..I think unnecessary C-sections are totally uncalled for!!! And I feel that if they can catch a preterm baby earlier there are many things they can do to keep the baby in the oven to bake a lot longer!!! Sorry so long.

Mandysays:

October 24, 2013 at 1:30 pm

I think this is great! I personally know several women who made it to 37 weeks and were induced just because. I also disagree with Robin, both of my children were born at 37 weeks, I went into spontaneous labor and both perfectly heathy. Not once did I think of my children as “premies” and even with these new guidelines, I still don’t think that. They both came out with healthy powerful lungs, scored great on the APGAR and have excelled ever sense. If you read the story closely it says “as evidenced by the fact that women who go into spontaneous labor at 37 or 38 weeks tend to have healthier babies than those who choose such early deliveries.” Otherwise the odds of you having a healthy baby spontaneously at 37 weeks is far greater than one induced at 37 weeks. Women should not feel bad for going into labor at 37 weeks. My Dr. explained to me that some women just grow babies faster. 40 weeks is an average, some women need 41! He told me that if I have any more children, I probably never will make it to 40 weeks.

jillykaye273says:

October 24, 2013 at 1:31 pm

Sorry that should say prior to 39 weeks. Should have proof read

Laurensays:

October 24, 2013 at 1:38 pm

I don’t understand the backlash against this. “Preterm” is not a bad word. And is your baby is preterm, but still healthy, then why does it matter if s/he is considered preterm? I really think that only good will come of it, especially if it diminishes elective preterm c-sections. My sister had to have a c-section at 37 weeks because of high blood pressure, and they determined that the baby was more likely 35 or 36 weeks. Fortunately he was healthy, just very small.

Amandasays:

October 24, 2013 at 1:38 pm

How about just outlawing inductions and c-sections before 39 weeks unless there is something medically significant that would require those actions? I don’t understand what difference re-defining this makes whether or not you make that rule. I already feel bad that I went into pre-term labor at 36 weeks. I don’t even know why- I had a picture perfect pregnancy, I went totally by the book. My son (born at a very healthy weight) had problems regulating his blood sugar and we were in the hospital a few extra days. I blamed myself the whole time, I blamed myself when he was a late walker and I have finally come to accept that it just happened that way, that he is catching up -and actually is pretty smart- and doing just fine and it was all in God’s plan not mine…

Lizzysays:

October 24, 2013 at 1:51 pm

I had my youngest by c/s at 37 weeks for medical reasons. For me, whose other babies were all 40+, I felt this was early and pre-mature and I wish I could have had her ‘bake’ a bit more as there have been complications.

At the time when I had the date, other moms kept telling me how lucky I was, and that it was ok because she would be full term.

For me I like the new definitions, and it fits much better for my LO. But I also have a friend who has perfectly healthy babies naturally, who has yet to get to the 37 week mark, always having at 35-36 weeks.

I do like discouraging early elective inducings and c/s.

Marysays:

October 24, 2013 at 1:55 pm

I think baby staying in until 39 weeks is good in theory but sometimes it just can’t happen. My second child was induced at 36 weeks due to cholestasis and he was perfectly healthy. With my third, I saw a diff doc an wanted it clear i wanted her out by 36 weeks. They argued that I had to wait until 39 weeks. Well with cholestasis the risk of still birth goes up dramatically each week after 36 weeks. I had to argue with them for over a month and they finally agreed on inducing at 37 weeks. My dd was born healthy and happy.

BakingNo.2says:

October 24, 2013 at 1:56 pm

My son was born a few days shy of 37 weeks — spontaneous labor — and had a very low APGAR. Other than a few days in the NICU he has been great.
But when I went to the doctor pregnant with No. 2, I mentioned off hand that my first was premature and the doctor was surprised. They hadn’t even noted it in the chart.
I had gestational diabetes with No. 2, and the doc kind of freaked because it was uncontrolled for a little while. He scheduled an induction at 37 weeks out of concern, but after seeing a specialist it was changed to 39 weeks. Luckily I went into labor a few days before.
I do think that it is best when labor comes naturally, but in some cases, like gestational diabetes, the possibility of stillbirth drastically increases at the end of the pregnancy. That is a good reason to induce if you have to.
I agree that the new terms are a bit inflammatory. Early term would be much better than late preterm. … especially when my actual preemie didn’t even merit a note in the chart.

Lizsays:

October 24, 2013 at 1:57 pm

I kind of agree with this. I was induced at 38 weeks due to pre-eclampsia and have always felt like my son has been slightly delayed (although not enough to be concerned). I think babies will come when they’re ready and unless there’s a medical emergency we should allow our bodies to make that decision.

Juliesays:

October 24, 2013 at 2:08 pm

As long as they don’t start trying to stop labor for the 37+ weekers who do go into labor on their own, I don’t see an issue with the new terminology. But my only other concern would be if the definition of ‘medically necessary’ isn’t well laid out, then I can see there being potential issues both ways.

My doc and the hospital had a disagreement on whether or not my induction was elective vs. medically necessary (it was at 39 weeks). Fetal movement was low, and she wasn’t responding to stimuli the way he wanted her to, but neither of these were so far outside the norm to trigger the hospital’s criteria. So, the hospital refused to schedule me when the doctor requested it, citing space issues for elective inductions. Doc felt strongly enough about it that he encouraged me to switch hospitals, and the second hospital followed the doc’s recommendations without question.

Baby was born healthy, but there were signs of a problem on the horizon(with the placenta, if I recall correctly – kiddo is now 10). Odds are really good that I was really close to spontaneous labor, and that my body would have handled it before it turned serious. BUT, it was disheartening to find that ‘guidelines’ were overriding doctor’s orders.

Melissasays:

October 24, 2013 at 2:10 pm

While I understand that, generally speaking, a baby born 39-41 weeks is healthiest, I don’t think that the definition for “term” should change. What about all those mothers who spontaneously go into labor at 37 weeks with a healthy baby? Most likely their due date was just wrong and the baby is not premature. It sure would be weird to say that your healthy 7-8 lbs. baby was “premature.” What I think would be better is just to change the week that people can choose to do a c-section or induction and state that the reason is because a “due date” is just an educated guess as to when baby will come, and it’s safer to either wait or to let baby come on their own, just to make up for the margin of error. Simple.

Jessicasays:

October 24, 2013 at 2:15 pm

I am not against induced labor or csection. Sometimes there are reasons to have one. In my second pregnancy i got diagnosed with stage 4 lupus with damage to my kidneys at 15 wks. Docs said they couldnt hope or do anything tilli was 23 wks. I had to go undergo chemo. I did many tests my son was so active everything seemed fine. And how i wish they would have induced me they kept telling me i was not going to make it full term. If they knew why wouldnt they let him out give him a chance. My baby passed away in my womb at 30 wks and 4 days. And my doc still got in trouble for giving me a csection. Like if i wanted to go through the pain of labor knowing that my baby was not gonna cry or move. The emotional pain still hit me after the csection but atleast it was quixk.

Colesays:

October 24, 2013 at 2:50 pm

I think it’s crazy to electively have a c-section/induction when there is no real reason other than being tired of being pregnant. I was induced with both my kids, with my son it was a week prior to my due date which was actually late according to my LMP and with my daughter it was two days. My son was 8lbs 4oz and my daughter was 8lbs 14oz, if she had been bigger, even 2 oz, they would have put her in the nicu because of being over the “weight limit” of possibly being diabetic. As it was they checked her sugars every 4 hours, she was fine. So it wasn’t really medically needed to be induced but it ended up being in our best interest in the end. With my son I was not showing any signs of going into spontaneous labor but once the induction was started my body knew what to do and he was born 4.5 hours after removal of cervidil tape.

My V.says:

October 24, 2013 at 3:07 pm

According to this, I had a late-preterm, spontaneous labor, with my first LO. He was born 37wks 5days. Healthy, no problems or issues. Went all natural–no pain killers and what not. Dilation was 2hrs and labor 4hrs. Doctor said were we good to go home anytime. My baby came full term according to my doctors. Although I believe the estimated due dates were off. First to third estimates changed from early April to late April-early May… LO came out early April. I don’t like the term changing when the real issue is about planned labor. They should change when planned labor can be permitted and adjust if there are real health risks.

Mariesays:

October 24, 2013 at 3:19 pm

I think they need to only induce as necessary and ensure they have the dates correct. With my older boy I was induced, because they insisted on going off my period date but I think he would have come on his own within a day or two. However with my second we went of the ultrasound and he moved out early, spent a week in NICU for feeding issues but has done everything on schedule and they did what they could to stop him until my water broke. I also question the brilliance of stopping labor with drugs around 35-36 weeks.

Jessica Houghsays:

October 24, 2013 at 5:28 pm

This sucks! My son was born a year ago at 37 weeks and weighed 8lbs7oz. I’m currently 34w3d pregnant and was counting down the days to 37weeks. I’m afraid of my baby being too big to deliver if I carry all the way to 40weeks. I will say I don’t support women who choose to induce or schedule unnecessary c/s. The baby will come when its ready and if it is too early, doctors know what to do.

momoftwosays:

October 24, 2013 at 5:53 pm

Thanks Jak! I’m on full bedrest and doing progesterone and trying my best to make it to at least 37!

Pamela Turbervillesays:

October 24, 2013 at 6:23 pm

This is ridiculous in my opinion, I had two children whom were both born at healthy weights at 37 weeks via c-section. I was pregnant a third time right about the time these particular changes went into effect. I had pre-term labor throughout my entire pregnancy and pretty much knew I would not make it to the required 38 weeks in order to do the csection, I went into the doctor’s office for a routine visit at 37.1 weeks and it was determined that I was possible in labor so he sent me to the hospital to be monitored for a few hours, I was later sent home because it was “too early”. I live an hour from the hospital. All night I was having pains the next day which was Saturday I decided to go to the town the hospital was in because my husband had an uncanny instinct that I was going to need to be there, we shopped most of the day and then went to visit family then my husband stated that we should go to the hospital just to be checked since I was having severe abdominal pain regularly, I was taken to the birthing floor and it was determined at 37.2 weeks that my third baby was clawing her way out of my previous c-section scar and that had my husband chose to go home instead of to the hospital that he would have lost his wife and daughter on his way home that day. I was rushed into surgery immediately and delivered a healthy 7lb 16oz baby girl who thankfully is here today because we pushed the doctors to check me and not wait until their idea of the perfect due date. Some of these regulations are a little ridiculous especially when previous pregnancies have taken place.

Kimberlysays:

October 24, 2013 at 6:48 pm

I have 5 that were past 40 weeks and one born at 30 weeks.

elenisays:

October 24, 2013 at 7:23 pm

when the baby wants to come out, he/she will come out no matter what. Induced labor before the baby is full term for convenience sake(?) And not for any other reason, is crazy.

elenisays:

October 24, 2013 at 7:27 pm

Jessica, so sorry for your loss.

Dianesays:

October 24, 2013 at 7:35 pm

Both my girls were born early. My oldest right at 37 weeks. My youngest at 37 weeks 5 days. With my first pitocin was used after the first eight hours because I was progressing but slower than the doctor would have liked. With the second no labor inducing drugs were used.

Kristasays:

October 24, 2013 at 8:13 pm

How does this apply to multiples? I’ve only had single births first being 40 weeks exactly second being 41 weeks and third being 39 weeks 3 days. I am currently pregnant with twins and they are recommending me to be induced around 36 weeks. My doctor insists twins/ multiple baby pregnancies are completely different, but I don’t want them to be born too early and have complications just because my doctor doesn’t want her job to be harder.

Eveline Beansays:

October 24, 2013 at 8:26 pm

This simply amazes me, I had a preemie in 1959 according to my ob docs. He was full 40 wks but only weighted 4 lbs 10 oz. Had to stay in hospital 3 wks until he reached 5 lbs.

Kathysays:

October 24, 2013 at 8:56 pm

First baby was due August 12 and I was induced August 20th, 9 pounds 10 ounces…2nd baby due Sept. 28, born Oct. 21, 9 pounds even…5th pregnancy was twin boys. One died at 35 weeks from cord breakage and they were both born at 39 weeks, one was 3 lbs 2 oz and the other 8 lb 2 oz(got gestational diabetes)….6th also gest. diab. but was fine. Induced at 50 weeks. 7th was gestational diabetes, found out that even though my glucose numbers were fine she was getting too big so they induced her at 39 weeks. Her body was too big for her head to engage and her cord prolapsed. Emergency C section, and she weighed 10 lb. 3 oz. Doctor said she NEVER would have engaged. I’m not for selective c’s or induction, but I am for trusting the experts!

Kathysays:

October 24, 2013 at 8:58 pm

I meant induced at 40 weeks, not 50!!!

Jaksays:

October 24, 2013 at 9:31 pm

Krista,
unless there is a medical complication that needs to be taken care of outside the womb asap those babies should be allowed to come out when THEY are ready. I wouldn’t trust a doctor who’s pushing me to evict for no good reason.

Pennysays:

October 24, 2013 at 11:14 pm

My little one was born at 31 weeks 1.2kg she is a preemie but the only way you can tell is that she is smaller that the other babys her age she was on venterlator for less the 24 hours and that was it she was in NNICU for 6 weeks only to gain weight and learn to suckle. There is nothing wrong with haveing a preemie baby and I also disagree with early birth if not for a medical reason and also C-section not sure why the hell anyone would want a C-section in the first place mine was due to medical reasons and the worst thing ever. 1st baby born natural at 39 weeks and 3 days and healthy

Asays:

October 25, 2013 at 12:20 am

I think parents put way to much emphasis on dates and weeks during pregnancy. Your due date is a guess, an educated guess but a guess. Just because you started your period on a certain day doesnt mean you ovulated 14 days prior (unless you keep excellent track of course). It is rare for a mom to know the exact day she became pregnant, so just because you THINK you are 38 weeks doesnt mean you are. You could only be 36 weeks. I think these new guidlines are amazing. I had a medically nessesary c-section at 38 weeks (what was considered full term) and my son spent 2 days in the NICU for breathing issues. I think I was only 35 or 36 weeks and he could have used at least one more week. He would have gotten just that if these new guidlines had been in place. Kind of makes me mad.

Deesays:

October 25, 2013 at 4:55 am

I had twins 13 years ago, and they were born around what we believed to have been at the beginning of their 37th week. Maybe they were still premature, but at least, at that time, they were already considered full-term, and didn’t have problems when they were born (we went natural too – we were the hospital DR main event, with probably half the OB-GYN department present!). I wasn’t induced, we refused elective c-section in spite of being told that it was the norm for a multiple pregnancy. Our doctor was a blessing to us, willing to wait for the natural turn of events: the only time she “rushed” was during the pushing time for the 2nd baby — contractions resumed naturally — and she noticed my cervix was beginning to close. But she scolded the intern who suddenly jumped on me and started “helping” me push without warning me first, reminding her that I had no anesthesia, and she was supposed to work with me and the baby, and not just do stuff without informing us first. We love my doctor!

Pamelasays:

October 25, 2013 at 7:03 am

I think it makes sense, however I think that it should be clarified that from what I read they do not call 37-38 weeks PREMATURE. Instead, they are introducing a new label called “early term.” The reason 37 was considering full term before was because for some babies, it is. But since for so many it is not, they realized they needed a new classification. It’s obviously a subtlety, but I think it’s worth noting that doctors are saying that 37-38 is not FULL term but they’re also not labelling it PRE-term. It’s just early term. Too risky for scheduled C-sections/inductions, but not really a scary-risk-have-an-incubator-on-hand emergency a genuinely premature baby is.

lksays:

October 25, 2013 at 2:01 pm

I totally agree with this article. I have always wondered why people would CHOSE to give birth early (except when medically necessary). The only thing that I laughed at was the line: “Delivery after 41 weeks has a higher risk of complications.” The reason is that my EASIEST labor was with my child that was born at 41 weeks 1 day.

Girl'sMamasays:

October 25, 2013 at 2:01 pm

I had to have a schedule c-section at 38 weeks due to previous surgery I could not sustain any labor safely without risking uteran rupture. We waited as long as we could in order to give baby as much cooking time as possible. She was healthy (7 pounds 14 ounces) & delivery wasn’t complicated (other that it was a C). I thought it was funny though- her ears weren’t finished. They were more like flaps on her head rather than cartilaged ears. They were fully formed by her original due date. Calling a healthy nearly 8 pounder a premie would have been silly though.

Lorrainesays:

October 25, 2013 at 3:06 pm

For those mothers-to-be and doctors who will induce or section for their convenience or just because they are finished “being pregnant” I say hooray. Let’s keep those babies in for as long as possible. I was always under the impression that 40 weeks was what I should shoot for. Even 42+ weeks is normal, normal for your baby. It is an estimated due date after all, it’s not a one size fits all scenario.
I understand that there are medical reasons to birth a baby ahead of schedule, but when there is no medical need there’s no excuse to rush baby’s development.

mom_of_6says:

October 26, 2013 at 7:15 pm

Nope, i don’t like it. I totally agree that elective early c/s and inductions are a horrible idea. However, I disagree with introducing a new “late term” label. Women who are trying to have a VBAC (vaginal birth after c-section) have a hard enough time avoiding a repeat c-section without giving their doctors additional “reasons” to not “allow” them to go “late”. My doctor scheduled a c-section for me at 41 weeks without my consent. I told her I wasn’t going, and delivered a perfectly healthy baby at 41+4 (vaginally!). I much prefer the (slightly elevated) risks of going past 41 weeks to the very real risks and complications of a c-section.

I strongly believe there needs to be just as much emphasis on avoiding elective inductions/c-sections before 42 weeks as there is before 39 weeks. There are times when elective procedures are helpful, but moms and doctors need to be aware of the risks before pushing to have them done.

Bethsays:

October 27, 2013 at 10:36 am

If you spontaneously went into labor at 37 weeks and had a healthy baby, why do you care if your baby is medically classified as “preterm” or “premature”?

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